Back when I first started with home bg testing (1982? 1983?), the docs knew I wasn't faking all the numbers because there were blood stains on the sheet. That hint let me succesfully fake some future sheets :-).
I truly hated bg testing back then. Today I would feel naked if I left the house with my bg meter and every so often for self-assurance I check that I have extra strips in my backpack.Awesome flatline!! And that log is a hilarious mess! May I ask why you have the Pump Alert circle indicator?? It looks like your pump 'thinks' there is insulin in there.
The circle is for the temp basal which is set to 0% for 24 hours!
LOL, I was floored to see it. I suppose it's sort of cheating to be using the pump to bolus but was pleased to see things fall into place like that with the trip coming up.
i guess it depends on what a high - low dose is. for those who take 9 units total or less, at least for me, splitting ended up being a real challenge because I'd burn out on both ends too soon. one never knows with levemir, as my endo said, for some it lasts all day, she has T1's on 1 dose of levemir, for some it only lasts 5 - 8 hours.
With the NovoPen Echo you can inject in 0.5 steps which is sufficient for me. With the Pendiq Pen and its 0.1 increments you can get close to the dosing of pumps. The unexplored potential space of MDI so to speak.
That's funny! I have bloodstains everywhere..ugh! So, AR...do you like being off the pump, does it feel liberating at all? Will you go back to pumping? Do you spike at all when you eat? what do you usually go to right after eating, on your CGM...just curious?
Ha! "Extorted" should read, "distorted," unless the high doses of Levemir threatened you! Can you tell I've been binge-watching the legal series Suits and The Good Wife?
Hey AR!
Great info on your transition. Levemir is my favorite insulin ever! Nothing gives me as steady and predictable basal rates like a split dose of Levemir. I've been pumping with Omnipods for quite some time now and find that I get near perfect control when I use Levemir for basal and the pod for bolus. As I've mentioned before, I travel internationally quite a bit and that can have a dramatic effect on my basal requirements, so I switch to full pod use (basal and bolus) when I travel, but when I'm home or traveling domestically nothing works better than my Levemir/Pod combo. The other thing that gives me great peace of mind is when I have the occasional pod failure its no big thing because my basal is covered by my Levemir. Yes, I cannot turn down my basal rate this way during exercise, but I can usually modulate this quite easily by having a glucose tab or two on hand if necessary.
All the best,
Christopher
I've seen other references to using pump/pod for bolus only, and I don't get it. As far as I can tell, there are only two real advantages to pumps/pods: 1. that it keeps track of all your insulin intake in an accessible database; 2. that it allows you to vary your basal rate throughout the day. If you're using a pump/pod for bolus only, then why not use a syringe? It is far less to carry and maintain, and doesn't require a 24hr subcutaneous catheter and all the downsides and excessive expense that carries with it.
I say this as one who is MDI all the way and also very happy with Levemir. It isn't perfectly flat with my current two split-dose routine, but I have learned how to tweak it with a couple small boluses to flatten it out. I record all my injections in my BG meter so the record keeping advantage of a pump isn't significant for me.
Hey Jag1
You raise a valid point and I'd probably be inclined to agree with you if I were using a tubed pump. Tubed pumps are more robust, reliable and I get the impression better at delivering an accurate basal rate. The downside that I'm not a big fan of is the tubing and worrying about where to keep/clip the pump.
The reason I enjoy the Levemir/Omnipod combo is that I can enjoy the best of both. Levemir gives me outstanding basal control, and peace of mind in the event of pump failure, and the Omnipod is so small and self-contained that I often forget its even there. Since the Omnipod controller (PDM) also doubles as a BG meter I only have to carry one device, instead of a meter and pens/needles or vial/syringes. The other benefit from this system is that I can make very small bolus corrections. I've found with even the most sophisticated 1/2 unit pens I don't really get an accurate dose unless I'm above 1 unit. There are 1/2 unit syringes...but then I'm back to carrying a vial with syringes.
But as I've said before - there is no "one best way." What's best is what works best for you. This is what gives me the best balance of control and convenience. Hope it make sense. :-)
Christopher
I agree there is no "best way", and I'm definitely not trying to convince you to change.
But if you don't mind, let me follow up on this. In your previous thread about your pod failing when you were travelling, you noted that if you hadn't been carrying your syringes and insulin you would have been screwed big-time. So if you're already carrying all the stuff (syringes and vials) you would need to go pure MDI, then you are actually carrying around MORE stuff to maintain your pod for bolus-only use - and certainly not carrying less. I agree syringes are easier to adjust for fractional doses (half units and even smaller is possible) - that's part of the reason I've never been a fan of pens.
I realized I left out one other possible advantage of a pump/pod over syringes, which is that you don't need to pull out your syringe every time you want to bolus. I guess that could be a big issue for some people; I've had T1 for so long that its second nature to me.
Glad to hear its working well AR… The real test will be once you get mdi dialed in will you actually want to go back to pumping or not— eager to hear
Congrats AR on your great transition to levemir. I am considering switching to MDI for a few weeks as well, but probably after dcamp. for me it is more out of "i need some new wind in my sails" as my basal is not working at all at the moment and i am just too frustrated. well, anyway, i will follow this discussion as maybe some more tips are shared.
Hey Jag1
No worries. No offense taken at all. In fact, I made that statement because I was worried I might be coming off a bit preachy and didn't want you to think I was trying to convince you or anyone else reading this thread, for that matter, that this was the only way to do things. At the end of the day, we are all just trying to manage the best way we can with the knowledge and resources we have available, along with the things we learn and best practices we develop along the way. The key reason I like this forum so much is that it gives me an opportunity to share my successes and challenges, and also learn from you and others.
You're absolutely right with your point regarding my pod failing while on a plane from a post I wrote a while back. But that is a different scenario: I definitely carry more when I travel, because when I travel it's all about redundancy. At home, I don’t, however. In fact, on that day I was relying on my pod for bolus and basal, so when it failed I really was in a dangerous situation. Thankfully I had my backup pens. It was a very sobering experience and a harsh reminder what a delicate balancing act we have to do 24/7 when fully insulin dependent. I try to make managing this disease as mundane as possible: just work it into my daily routine and not let it dominate my life. The risk, however, especially when I've had a particularly good run of numbers, is that complacency and a cavalier attitude can set in, and I’m only reminded how vulnerable I am when faced with a scenario like that.
My work requires considerable travel to some very distant places. I have only myself to rely on and there are some places I travel where I know I’d be in a life-threatening situation quickly if a pod were to fail, or my insulin were to go bad or get lost. I keep extra insulin, needles and pens in my briefcase, and extra pods, Dexcom supplies and spare receiver, meter, insulin, needles and pens in my carry-on. If I check luggage, which I rarely do, I will pack extra supplies there too, except insulin, because of the risk of it getting cooked.
I share your feelings about injecting in public when on MDI. I couldn’t be bothered what people might think, but it has occasionally led to some humorous situations: like when a waitress almost fainted at the sight of my needles.
All the best,
Christopher
Woah, back from vacation and my experience there didn't work out nearly as smoothly. I found the 5 time zone transition to be rough and seem to have made numerous blunders, fiddling with basal to avoid going low during planned activities (snorkeling, the road to Hana, surfing, swimming, etc.). It was quite a roller-coastery ride but I survived. I was really relieved to plug my pump and CGM back in after surfing on Thursday and immediately felt more "solid", it was weird how within an hour or so (we were running around a bunch getting ready to leave...), I felt a lot more together and in conrol of stuff. Perhaps treating lows with Mai Tai's (I guessed about 25G of carbs but Calorie King lists them at 34!) wasn't the best choice!
Unfortunately, I forgot my log and probably would not have kept it very accurately anyway. Still, it was a great trip and an interesting experiment. I will definitely talk to the doc about getting more organized about the dosages and stuff too. The first day I shaved off too much, having taken a "short" dose that night to cover the time change and then another short dose in the AM, this sort of started a high day, I got back to the "normal" dose I'd figured out the next day which got a bit hairy after a run (a good run, also a useful way to explore Lahaina) as I ended up at 29! The rest of the day, I ended up running high, perhaps "stacking" both the rebound from the low and very aggressive eating, as Mrs and Junior are big fans of Asian cuisine which tends towards noodles/ pork rolls/ etc. and perhaps I should have held back, oh well, when in Rome... The Third Day, was more of the same so day 4 I figured I'd take more basal and set out for a longer run (a couple ticks over 7 miles, kicking off marathon training! Yay, I think!) and was still low (50 something) when I finished but not as low. Post run, the low would *not* go away but eventually things settled down a bit.
All in all it was a lot of work. On the plus side, I think that all the highs reduced hypoglycemic unawareness as the lows produced sweating, etc. that I haven't seen for a while. The shots also provided a nice break for my abdomen, in terms of scar tissue as the first site afterwords seemed to work very nicely. I'm sure that I could get the Levemir smoothed out with more practice but I don't think that I'm dedicated enough to the process to get into it. I just figured I'd toss this totally unscientific account out in case anyone is curious! Aloha!